Meeting the psychological needs of cardiac patients: an integrated stepped-care approach within a cardiac rehabilitation setting

摘要

Depression and anxiety are commonly experienced by cardiac patients and are associated with reduced quality of life and mortality, but the evidence for the effectiveness of medical and psychological treatments for depression has been mixed.We explored the psychological needs of cardiac patients and developed a stepped-care model of psychological care, which was both accessible and acceptable to cardiac patients. The clinical psychologist was integral to the cardiac rehabilitation team and provided joint working, support and a range of interventions.Preliminary evidence suggests that offering a range of psychological treatments might be an effective way of meeting cardiac patients' psychological needs. Specific psychological interventions included: psycho-education sessions addressing behavioural risk factors and adjustment, brief individual therapy for patients with mild-to-moderate, as well as for those with severe, mental illness, group workshops and individual therapy, using cognitive-behaviour therapy for anxiety, depression and adjustment to adverse life events.